- Hi, I'm Bob Trump, physical therapist,
- Brad Heineck physical therapist.
- And together we are the most
famous physical therapist on the internet.
- In our opinion, of course Bob.
- Brad, I was very surprised the other day.
You're looking at my hand when I'm waving it.
I was very surprised the other day, someone had mentioned
that we've never really done one on, on treating the neck.
And I, I think we've done some like for a stiff neck
but I don't think we've ever really done one on treating,
treating the neck.
- Right. So yeah. What, what do we got here?
- Top three exercises to stop neck pain.
- Sure. All right.
- And this is what you want to keep in mind.
First off, if you're having neck pain for the first time um,
we would probably suggest that you want to go see a doctor.
- Uh huh
- If this is the first time you've ever had it,
it could be a lot of other things.
But if this is something that's recurrent
or you, you've, you're always having neck pain
this is a good one for you to try.
- Sure.
- All right.
And this is neck and arm pain, by the way
not just neck pain, especially
if the arm pain seems to be coming from the neck.
- Right.
- And when we're selecting these exercises
cause you're gonna, we're, we're kind of trying to
make a choice of which exercise to use.
You're gonna do it based upon this one issue.
You really need to understand this.
Let's say, for example, that here's a person and
and we're viewing him from the back.
- Right?
- And uh what he, here
this is the area of pain that we're looking at.
This patient has very severe pain.
It goes all the way from the neck, into the shoulder blade
down the arm, all the way into the hand.
So when we start doing exercises, what we wanna see is
that the pain starts leaving
the hand and the arm.
You know, if it even goes up that much
that's a great improvement.
- Right. Right.
- All right.
Eventually what you want to see is
that it actually what we call centralizes
- Sure
it all starts to focus right.
In the neck itself.
Sometimes it can even get a little more intense there.
- Right. Right.
- Brad. But most people seem to know Brad
when this it's like, yeah. It's taking away the pain.
- Yeah. And it'll happen.
- Right.
- Pretty quickly.
On the other hand, if the pain from the exercise gets better
up in here, but worse down in here in the hand, that's
Opposite.
- Yeah. That's the opposite. You stop.
And, and and then you just can't do this.
You need to see a therapist or something
- Uh huh
- so that you're right Brad.
If let's say you start and your pain is
in this area here and then you do the exercise
and it starts going down here.
That's that's an absolute contraindication
- Big red flag
- Big red flag yep
- Uh huh
Now your pain might be, you might also be
having pain over here.
- Yeah.
- And here to start off with, um and it would
be the same with that.
When you do the exercises, you wanna see that it
it starts leaving the upper
(board sliding sound)
- Whoa,
- oh there ya go. upper shoulders and, and goes
into the neck.
I'm sorry to spend so much time on this, but you really
need to understand this
- Right
- while we're doing these exercises
- And and you might wonder
why does the pain go down the arm?
I'm not gonna go into the detail, but the
the nerves actually go from the neck
and go down into the arm and it follows the nerve track
Et cetera.
- So, alright,
- Okay
- now we know what we have to do.
We have to get that pain, getting out of the arm
getting out of the shoulder blade.
So let's, this is what we start with.
We're gonna start off with chin tucks, Brad.
- Yeah
- This is the one everybody starts with.
You're gonna be doing this one.
I just realize we are gonna have to lay
down at once some point.
- Oh yeah.
- Um, So chin tucks, Brad, Brad and I will be both doing it.
Um you want to have good posture in a chair.
- Not tall, not slouched
- Not tall. Yeah. Not slouch.
And you're actually going to tuck your chin back.
- Yep.
- Now Brad, what's the thing you always say
you always say, don't be going down like this.
- Right, don't look down.
Pretend like someone's taking a pie
and they're gonna put it in your face.
And you're just gonna back your face up.
- Yeah.
- Or like there's a shelf here.
And you slide your chin on that shelf.
- Yeah.
- If you want, you can do a little
over pressure like this, but that's not necessary.
- Yeah. And uh people do it different ways.
Some people hook it like this and give a little
over pressure, um but you can go ahead and do pressure
on, pressure off, pressure on, pressure off 10 times.
And you're gonna do this actually almost every hour
or six to eight times a day.
That's crazy. But that's
- And, and when you do it,
you should get some centralization of that
pain coming out of the arm and going up towards the
shoulder and the neck.
- At the very least it shouldn't get worse with this one.
- Right.
Yeah. If you do this, it might hurt at first,
- Uh huh
- Brad but within, you know, 3, 4, 5 reps, it should either
just maintain the same
or it should get any or it should get better.
- Right.
- Yeah. So
- On the other hand of it,
five and six is getting worse and worse.
Then you stop.
- Then you stop.
Yep. Now, along with this one
you always wanna do the extension then too.
- Uh huh
- So you're gonna start the extension
by first doing a few of these few of the chin tucks.
- Yep.
- And then you're gonna go back like this and
and lean back. Now while you're back here,
And again, you're gonna wanna start feeling that, you know
after doing a bunch of repetition, that some
of the pain is getting better. While you're back here
you're actually gonna turn your nose one inch to the left
one inch to the right.
And while you're turning it back
you're trying to go back further and further and further.
- Right.
- Okay.
- Now
- You wanna show it to them?
- Right. And again, remember when you do this
and I've experienced it
myself and with many patients, if they're doing this
and they say, oh, it hurts right back in here.
Then I'll ask them how does the arm feel?
And the arm feels better.
- Right.
- Then you can,
- Yeah
- you can continue to do it. Lean back
- And further and further, the further you can go
and you can see, we actually like these solid back chairs
that kind of hit you mid shoulder blade.
- Right. Uh huh.
- Because you can lean up back over them and even go back
- Right.
- Further.
- Now, what I do, and I think Bob does this too.
We were talking about this. This is kind of working.
So we're gonna full extension, but it hurts
and they can't quite do it.
- Right.
- And and then we go to some support with the towel roll.
- Exactly.
- And I think you and I have different ways
to roll up the towel
- Yeah.
- but it's not that important.
And then I'll have them do this.
they say, oh yeah. That's that feels better.
It's more controllable. It feels better.
And then after they do the full extension
with some support here, then you can start to do it without
- Exactly.
- So it's a progression.
- Let's take the worst case scenario.
- Okay
- Let's take, let's say you start doing these.
Ah, it, it actually maybe makes it even a little worse.
- Yep.
- Or, and then you do these, and it makes it a little worse.
Then you're gonna actually start
on the mat and you're gonna lay down,
got me Lonnie?
- [Lonnie] Yep.
- And you're gonna do your chin tucks this way.
And it's the same thing.
Now this is, we've taken all the weight
off the head
- Uh huh
- and the neck.
So it, it really should not cause increased pain.
If you get numbness or tickling
down your arm, or pain, then you.
Yeah you definitely have to see the doctor and
and this is just not working
but otherwise you start with this now
and then and then you go to the one with the towel.
- Right.
- If you're having a lot of pain.
- Right.
- So this would be the option of
you know, in case you're having too much pain to
even do it the other way, the first time.
- Right.
- So it's the same exercise, chin tucks.
But you're on the mat.
Sometimes I have maybe even a little towel here, Brad?
- Yeah. This is
- A little rolled towel
- And I'll give verbal cues.
Why don't you put your head down?
And I'll say, I'll put my fingers here and I'll say
to the patient, can you try and touch your neck
against my fingers?
And so now I can feel them pinch my fingers there.
- Yeah. I'm Not trying to bring my chin down like this.
I'm just trying to bring it back.
- Yeah. It's a strange motion.
It takes a little bit to get
to get to coordinated, to do it.
If you haven't thought about it or done it before.
- So with some people with a actually 80% of the people
- Uh huh
- they get relief from one of these exercises, we still
have one more to do.
- Right.
- But generally a lot of times that, you know
by doing the chin tucks and going to this
and eventually when they get way, way, way back
and they're turning their
neck like this, they get way way back.
Eventually a lot of times the pain goes away.
- Right.
- But there are some where it
it just kind of seems to stall.
And this was me.
So I, I, I experienced this myself
and I was having pain down my right arm.
- Uh huh
- Not that far, but down here.
And what I had to do then
is what we call right side bending.
- Uh huh.
- So if the pain's on this side, you're gonna go ahead
and do your chin tuck, and then you're gonna bend your ear
to the right shoulder, chin tuck, ear to the right shoulder
chin tuck ear to the right shoulder.
- Right.
- Any comments, Brad?
- Well again
- Don't bend the shoulder up.
- Right. And again, it's the same thing after you do the
first couple three, the symptoms of pain should
start coming down or centralizing.
If it doesn't, you need to get some help.
- And this I found and I probably overdid,
Well I did a lot of these the first day and I got sore.
I really got sore up in the neck
but it did take this away.
The next day I'm like it was gone.
- Uh huh.
- So it worked great.
And I just had one of my last patients I've had that.
I used this with, he was a dentist and it
we also had to go to these and it just took it away.
- Sure.
- He was real right-handed
- Yeah
- and uh, he, I mean it was affecting his practice.
He wasn't even gonna be able to work anymore.
- Right.
- So it worked really great.
If the pain's going down the left arm, same thing,
chin tuck, bend to the left.
Chin tuck, bend to the left
- Sure You bet.
- So those are the three exercises.
It's chin tucks, extensions, and side bend.
You might not have to do the side bend if
if the other two take it away.
- Right. You bet.
- So again, we've had great luck with this.
Um, it's the McKenzie method.
- Right.
I'll put their, their uh website again on, on down below.
So in case people wanna look into it further.
- Right.
- So.
- They're a very popular treatment throughout the world
and it promotes self-treatment
and you should always have improvement from the exercises.
If you don't, you stop.
- Right. All right. Good luck to you.